Center for Medicare and Medicaid Services Delays Effective Date of New Bundled Payment Models

On March 21st, 2017, the Center for Medicare and Medicaid Services (CMS) released an interim final rule that further delays the effective date of the Advancing Care Coordination through Episode Payment Models (EPM’s), the Cardiac Rehabilitation Incentive Payment Model, and changes to the Comprehensive Care for Joint Replacement Model from July 1, 2017 to October 1, 2017.

These models currently mandate bundled payment programs in select service areas for heart attacks and bypass surgery, as well as new coverage for surgical hip and femur fractures. In the interim final rule, CMS notes it may be less burdensome to participants to implement the EPM’s and changes to CJR based on a calendar year and is considering a further delay of the effective date to January 1, 2018.

This additional delay would also allow time for CMS to make potential modifications to the programs and insure participants have a clear understanding of any changes that are made. CMS is accepting stakeholder comment until April 19, 2017. At this point, it is unclear what modifications may be made, but there is the potential CMS will remove the mandatory nature of the EPM model. CMS believes this may lead to more engaged healthcare providers. Medicare’s Bundled Payments for Care Improvement (BPCI) initiative and the original CJR models will remain intact.

With ongoing uncertainty surrounding these programs, Preferred Therapy Solutions will continue to monitor the situation and keep our valued partners updated.

As your Rehabilitation Partner, Preferred Therapy Solutions continues to collaborate with your facility and Interdisciplinary Team to support and coordinate ADR and appeals activity. If you have any questions, please contact Maria Maggi, PT / Vice President of Compliance